New UMass Memorial chief targets reform

Thursday

Mar 21, 2013 at 6:00 AMMar 21, 2013 at 10:37 AM

By Bronislaus B. Kush TELEGRAM & GAZETTE STAFF

The new president and chief executive officer of UMass Memorial Health Care said local health care costs could be substantially lowered and services markedly improved — if area providers, patients and political leaders work together to create an innovative delivery system tailored to the needs of the region.

Dr. Eric W. Dickson, the new UMass Memorial chief, told those attending the annual F.J. Aspinwall Symposium at Worcester Polytechnic Institute Wednesday that it's possible to come up with better health care systems in a place like Worcester, where all the players know each other.

“You couldn't do this in Boston,” he said.

To begin with, he said, local partners should work on “one or two things” before moving on to other ideas.

He described the process that several similarly sized health care systems — in Wisconsin and Utah — that might serve to help Worcester's health care system achieve efficiencies and improve quality.

Costs decreased by 33 percent and health care improved overall in the Green Bay region of Wisconsin, he said, after Bellin Health implemented innovations that included getting consumers to visit newly established “mini-fast track clinics,” rather than area emergency rooms.

Bellin used the carrot, rather than the stick, by waiving co-payments for patients opting to use the clinics, Dr. Dickson said, noting that Bellin experimented with its employees before rolling out a plan for the community.

He said another Wisconsin provider, Theda Care, saw similar results after following the philosophy of management at Toyota Motor Corp., which told its employees to build not just cars, but “better cars”: Theda Care officials encouraged their workers that they should not only take care of their patients, but provide better services.

In addition, Theda Care circumvented middle management and urged employees to generate “a pool of ideas,” Dr. Dickson said. The proposals were placed on sheets of paper posted on “huddle boards” so that other employees might have the chance to improve on the idea proposed by a fellow colleague.

“The employees could say, 'No, I can make this (idea) a little better,' ” said Dr. Dickson. “People who do the work know how to fix the problems.”

He said the concept generated about 30,000 ideas, or about six proposals per employee, netting improvements to the health care systems.

Dr. Dickson also cited Intermountain Health Care in Salt Lake City, which streamlined its system by providing standardized care.

While doctors very often have their “own way” of doing things, which can create a hodgepodge of issues, Dr. Dickson said, Intermountain's efforts at standardization — through consensus — resulted in efficiencies and better care. He said the care was tweaked in cases of individual need.

Dr. Dickson said health care can be improved, provided that those involved are:

•Transparent about costs;

•Honest about the quality of care;

•Support innovations at all levels;

•Support new payment mechanism;

•And, work together as community.

He said something has to be done to get control of spiraling national health care costs.

“Health care costs too much and delivers too little,” Dr. Dickson said, adding that he is worried about more cuts to the funding of the National Institutes of Health, which provides money for health care initiatives.

According to Dr. Dickson, about $2.8 trillion is spent annually on health care. Yet the United States, he said, lags behind other industrialized nations such as Australia, Canada, Germany, the Netherlands and the United Kingdom in providing quality care.

Dr. Dickson said U.S. leaders are looking to cut health care costs by creating incentives for healthy behavior, forcing people to shop for cheaper care, and reducing government payments for services provided, among other ideas.